Active NPI
Samantha Hudzietz
- Behavior Technician
- Campbell, CA
National Provider Identifier
1134736119
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 256 E Hamilton Ave Ste C
Campbell, CA 95008-0237 - Phone
- (844) 322-7483
- Fax
- (844) 322-7483
- NPI assigned
- Sep 24, 2020
- Last updated
- Sep 24, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | NU | Primary |
Addresses
Primary practice location
256 E Hamilton Ave Ste C
Campbell, CA 95008-0237
Mailing address
749 37TH Ave
Santa Cruz, CA 95062-5124
Phone (844) 322-7483
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jessica Lieber, M.S., Bcba | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600905600000",
"number": "1134736119",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "749 37TH AVE",
"city": "SANTA CRUZ",
"state": "CA",
"postal_code": "950625124",
"telephone_number": "844-322-7483",
"fax_number": "888-334-7021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "256 E HAMILTON AVE STE C",
"city": "CAMPBELL",
"state": "CA",
"postal_code": "950080237",
"telephone_number": "844-322-7483",
"fax_number": "844-322-7483"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUDZIETZ",
"first_name": "SAMANTHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-24",
"last_updated": "2020-09-24",
"certification_date": "2020-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Campbell, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.